Provider Demographics
NPI:1013732825
Name:POWELL, RAMONA MACIEJNY (RPH)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:MACIEJNY
Last Name:POWELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:RAMONA
Other - Middle Name:BARBARA
Other - Last Name:MACIEJNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:54 OLD TROLLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-4904
Mailing Address - Country:US
Mailing Address - Phone:843-871-5159
Mailing Address - Fax:
Practice Address - Street 1:54 OLD TROLLEY RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-4904
Practice Address - Country:US
Practice Address - Phone:843-871-5159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC60427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist